olanzapine and Bradycardia

Topics: Bradycardia; Humans; Olanzapine

This is a case of a citalopram and olanzapine overdose causing seizures and severe cardiotoxicity.. A 21-year-old man presented unresponsive, with seizures, to an Emergency Department. The patient's initial electrocardiogram demonstrated a widened QRS of 160 ms and a normal QT/QTc interval of 400/487 ms consistent with cardiac sodium channel blockade. Within 30 min of arrival, peak citalopram and olanzapine levels were measured to be 522 ng/mL and 505 ng/mL, respectively. Measured levels remained supratherapeutic until 13.6 h and 42.6 h after arrival for citalopram and olanzapine, respectively. The patient developed bradycardia and hypotension that required multimodal therapies including sodium bicarbonate boluses, vasopressors, and transvenous pacing. Seizures and cardiotoxicity continued while citalopram, but not olanzapine, was supratherapeutic.. This case describes cardiotoxicity directly correlated with supratherapeutic citalopram levels in overdose.

Topics: Adult; Benzodiazepines; Bradycardia; Citalopram; Drug Overdose; Electrocardiography; Humans; Hypotension; Male; Olanzapine; Seizures; Selective Serotonin Reuptake Inhibitors; Young Adult

Topics: Antipsychotic Agents; Benzodiazepines; Bradycardia; Dose-Response Relationship, Drug; Humans; Male; Middle Aged; Olanzapine; Schizophrenia, Paranoid; Severity of Illness Index

Olanzapine, an atypical antipsychotic, is often regarded as a safe choice for psychosis management. We hereby report an aged case that presented with conscious depression, bradycardia, hypotension, miosis and hypothermia. Olanzapine was thought to be the offending agent. His condition improved with supportive therapy.

Topics: Age Factors; Aged; Aged, 80 and over; Antipsychotic Agents; Benzodiazepines; Bradycardia; Cardiovascular Diseases; Delusions; Dementia; Humans; Hypotension; Hypothermia; Male; Olanzapine

Olanzapine is an atypical antipsychotic medication indicated for the treatment of schizophrenia and other manifestations of psychotic illness. Common side effects include somnolence, constipation, weight gain, and postural hypotension. The authors report a case of hypotension accompanied by bradycardia in a normal, healthy volunteer participating in an olanzapine pharmacokinetic study following a single 5 mg dose. A venous catheter allowed for serial blood sampling of olanzapine concentrations before, during, and after the adverse event. The subject experienced a rapid absorption of the drug and higher than anticipated maximum plasma concentrations. This case suggests that atypical antipsychotics, although generally better tolerated than conventional agents, may still result in untoward reactions that may be partially due to individual differences in drug absorption and metabolism.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Blood Pressure; Bradycardia; Double-Blind Method; Female; Heart Rate; Humans; Hypotension; Olanzapine; Pirenzepine

We report the case of a 43-year-old schizophrenic who sustained, after 12 days of treatment including olanzapine (20 mg.day-1), carbamazepine, levomepromazine and alprazolan, a severe shock with bradycardia (HR: 40 b.min-1), circulatory collapse (SAP: 60 mmHg), hypothermia (T: 27 degrees C), coma and disseminated intravascular coagulation. A significant improvement was obtained with high doses of intravenous glucagon, whereas the normalization of central temperature, atropine, adrenaline and volume loading had been inefficient. Olanzapine, alone of associated with other psychotropics, could cause severe circulatory collapse with hypothermia and coma responding to a treatment including glucagon.

Topics: Adult; Alprazolam; Antipsychotic Agents; Benzodiazepines; Bradycardia; Carbamazepine; Disseminated Intravascular Coagulation; Drug Therapy, Combination; Gastrointestinal Agents; Glucagon; Humans; Hypothermia; Infusions, Intravenous; Male; Methotrimeprazine; Olanzapine; Pirenzepine; Schizophrenia; Shock